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| 2. |
- Engström, A E, et al.
(author)
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Mechanical circulatory support with the Impella 5.0 device for postcardiotomy cardiogenic shock: a three-center experience
- 2013
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In: Minerva Cardioangiologica. - : Edizione Minerva Medica. - 0026-4725 .- 1827-1618. ; 61:5, s. 539-546
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Journal article (peer-reviewed)abstract
- AIM:Postcardiotomy cardiogenic shock (PCCS) is associated with high mortality rates, despite full conventional treatment. Although the results of treatment with surgically implantable ventricular assist devices have been encouraging, the invasiveness of this treatment limits its applicability. Several less invasive devices have been developed, including the Impella system. The objective of this study was to describe our three-center experience with the Impella 5.0 device in the setting of PCCS.METHODS:From January 2004 through December 2010, a total of 46 patients were diagnosed with treatment-refractory PCCS and treated with the Impella 5.0 percutaneous left ventricular assist device at three european heart centers. Baseline and follow-up characteristics were collected retrospectively and entered into a dedicated database.RESULTS:Within the study cohort of 46 patients, mean logistic and additive EuroSCORES were 24 ± 19 and 10 ± 4. The majority of patients underwent coronary artery bypass grafting (48%) or combined surgery (33%). Half of all patients had been treated with an intra-aortic balloon pump before 5.0-implantation, 1 patient had been treated with an Impella 2.5 device. All patients were on mechanical ventilation and intravenous inotropes. The Kaplan-Meier estimate of overall 30-day survival was 39.5%.CONCLUSION:Thirty-day survival rates for patients with PCCS, refractory to aggressive conventional treatment and treated with the Impella 5.0 device, are comparable to those reported in studies evaluating surgically implantable VADs, whereas the Impella system is much less invasive. Therefore, mechanical circulatory support with the Impella 5.0 device is a suitable treatment modality for patients with severe PCCS.
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| 4. |
- Berg, Staffan, et al.
(author)
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In Vitro and In Vivo Evaluation of 3D Printed Capsules with Pressure Triggered Release Mechanism for Oral Peptide Delivery
- 2021
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In: Journal of Pharmaceutical Sciences. - : Elsevier BV. - 0022-3549 .- 1520-6017. ; 110:1, s. 228-238
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Journal article (peer-reviewed)abstract
- In this study a 3D printed capsule designed to break from the physiological pressures in the antropyloric region was evaluated for its ability to deliver the synthetic octapeptide octreotide in beagle dogs when co-formulated with the permeation enhancer sodium caprate. The pressure sensitive capsules were compared to traditional enteric coated hard gelatin capsules and enteric coated tablets. Paracetamol, which is completely absorbed in dogs, was included in the formulations and used as an absorption marker to give information about the in vivo performance of the dosage forms. The pressure sensitive capsules released drug in 50% of the dogs. In the cases where drug was released, there was no difference in octreotide bioavailability or C-max compared to the enteric coated dosage forms. When comparing all dosage forms, a correlation was seen between paracetamol C-max and octreotide bioavailability, suggesting that a high drug release rate may be beneficial for peptide absorption when delivered together with sodium caprate. (C) 2020 Published by Elsevier Inc.
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| 8. |
- Wolever, Thomas M S, et al.
(author)
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Measuring the glycemic index of foods: interlaboratory study.
- 2008
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In: The American journal of clinical nutrition. - 0002-9165 .- 1938-3207. ; 87:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Many laboratories offer glycemic index (GI) services. OBJECTIVE: We assessed the performance of the method used to measure GI. DESIGN: The GI of cheese-puffs and fruit-leather (centrally provided) was measured in 28 laboratories (n=311 subjects) by using the FAO/WHO method. The laboratories reported the results of their calculations and sent the raw data for recalculation centrally. RESULTS: Values for the incremental area under the curve (AUC) reported by 54% of the laboratories differed from central calculations. Because of this and other differences in data analysis, 19% of reported food GI values differed by >5 units from those calculated centrally. GI values in individual subjects were unrelated to age, sex, ethnicity, body mass index, or AUC but were negatively related to within-individual variation (P=0.033) expressed as the CV of the AUC for repeated reference food tests (refCV). The between-laboratory GI values (mean+/-SD) for cheese-puffs and fruit-leather were 74.3+/-10.5 and 33.2+/-7.2, respectively. The mean laboratory GI was related to refCV (P=0.003) and the type of restrictions on alcohol consumption before the test (P=0.006, r2=0.509 for model). The within-laboratory SD of GI was related to refCV (P<0.001), the glucose analysis method (P=0.010), whether glucose measures were duplicated (P=0.008), and restrictions on dinner the night before (P=0.013, r2=0.810 for model). CONCLUSIONS: The between-laboratory SD of the GI values is approximately 9. Standardized data analysis and low within-subject variation (refCV<30%) are required for accuracy. The results suggest that common misconceptions exist about which factors do and do not need to be controlled to improve precision. Controlled studies and cost-benefit analyses are needed to optimize GI methodology. The trial was registered at clinicaltrials.gov as NCT00260858.
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| 9. |
- Carrera-Bastos, Pedro, et al.
(author)
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C-reactive protein in traditional melanesians on Kitava
- 2020
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In: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 20:1
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Journal article (peer-reviewed)abstract
- Background: Population-based levels of the chronic low-grade systemic inflammation biomarker, C-reactive protein (CRP), vary widely among traditional populations, despite their apparent absence of chronic conditions associated with chronic low-grade systemic inflammation, such as type 2 diabetes, metabolic syndrome and cardiovascular disease. We have previously reported an apparent absence of aforementioned conditions amongst the traditional Melanesian horticulturalists of Kitava, Trobriand Islands, Papua New Guinea. Our objective in this study was to clarify associations between chronic low-grade systemic inflammation and chronic cardiometabolic conditions by measuring CRP in a Kitava population sample. For comparison purposes, CRP was also measured in Swedish controls matched for age and gender. Methods: Fasting levels of serum CRP were measured cross-sectionally in ≥ 40-year-old Kitavans (N = 79) and Swedish controls (N = 83). Results: CRP was lower for Kitavans compared to Swedish controls (Mdn 0.5 mg/L range 0.1—48 mg/L and Mdn 1.1 mg/L range 0.1—33 mg/L, respectively, r =.18 p =.02). Among Kitavans, there were small negative associations between lnCRP for CRP values < 10 and total, low-density lipoprotein (LDL) and non-high-density lipoprotein (non-HDL) cholesterol. Among Swedish controls, associations of lnCRP for CRP values < 10 were medium positive with weight, body mass index, waist circumference, hip circumference and waist-hip ratio and low positive with triglyceride, total cholesterol-HDL cholesterol ratio, triglyceride-HDL cholesterol ratio and serum insulin. Conclusions: Chronic low-grade systemic inflammation, measured as CRP, was lower among Kitavans compared to Swedish controls, indicating a lower and average cardiovascular risk, respectively, for these populations.
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| 10. |
- Engberg, Birgitta A., Docent, 1975-, et al.
(author)
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Abrasive refining of spruce TMP and CTMP fibers
- 2022
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In: Proceedings of the International Mechanical Pulping Conference. ; , s. 57-62
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Conference paper (other academic/artistic)abstract
- Most of the earlier proposed ways to reduce energy con-sumption in high consistency refining requires operating at a small disc gap. However, a small gap is often associated with a severe fiber length reduction and often lead to unsta-ble refining and a small operational window. To address these issues, the idea of utilizing abrasive segments surfaces is here revisited. Abrasive refiner segments, consisting of abrasive surfaces in combinations with traditional bars and grooves or flat abrasive surfaces without any bars or grooves, were evaluated in both pilot and mill scale. From the trials it could be concluded, that particularly stable refin-ing was achieved with less power variations compared to when using standard segments, even when refining at very small disc gaps. The lw-mean fiber length of the pulps was not reduced or only slightly reduced, even when refining at very small disc gaps. Tensile index could be increased more efficiently or equally efficient as when using standard seg-ments. Improved energy efficiency could be achieved when combining the abrasive surface with high intensity treat-ment.
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| 11. |
- Fontes Villalba, Maelan, et al.
(author)
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A healthy diet with and without cereal grains and dairy products in patients with type 2 diabetes: study protocol for a random-order cross-over pilot study - Alimentation and Diabetes in Lanzarote -ADILAN.
- 2014
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In: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 15:1
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Journal article (peer-reviewed)abstract
- Research on the role of nutrition in type 2 diabetes has largely focused on macro/micronutrient composition and dietary fiber intake, while fewer studies have tested the effects of differing food choice. Some observational studies and short-term intervention studies suggest that a food pattern mimicking the diet with which humans evolved positively influences glucose control and associated endocrine systems. Such a food pattern mainly differs from other common healthy food patterns in its absence of cereal grains and dairy products. The primary aim of this pilot study is to determine the effect of two healthy diets with or without cereal grains and dairy products on glucose control, while keeping participants' weight stable and other food parameters, such as macro/micronutrient composition, dietary fiber and glycemic load, the same in both diets.
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| 12. |
- Fontes-Villalba, Maelán, et al.
(author)
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Effects of a Paleolithic diet compared to a diabetes diet on leptin binding inhibition in secondary analysis of a randomised cross-over study
- 2024
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In: BMC Endocrine Disorders. - 1472-6823. ; 24, s. 1-7
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Journal article (peer-reviewed)abstract
- BACKGROUND: Beneficial effects from practising a Paleolithic diet as compared to a diabetes diet on weight, waist circumference, satiety, leptin, HbA1c and glucose control in randomised controlled trial participants with type 2 diabetes could be due to lower leptin resistance. Support for this hypothesis comes from an in vitro experiment that showed that digested wheat gluten, which is excluded from a Paleolithic diet, inhibits leptin from binding to its receptor, thus indicating a possible dietary cause of leptin resistance. However, the clinical relevance of the latter finding is unclear since removal of enzyme activity from the gluten digest by heat treatment also abolished leptin binding inhibition. Assessment of leptin binding inhibition in vivo is possible by comparison of total leptin levels with those of 'biologically active' leptin bound to its receptor (bioLep).OBJECTIVES: To assess the effects of a Paleolithic diet compared to a diabetes diet on leptin binding inhibition and to replicate our in vitro study.METHODS: BioLep and total leptin levels were measured in secondary analysis of fasting plasma samples from our open label random order three plus three-month long cross-over trial performed in 2005-2007, that compared a Paleolithic diet with a diabetes diet in participants with type 2 diabetes without insulin treatment (per protocol). BioLep was also measured in vitro for known recombinant leptin concentrations incubated with a series of concentrations of 10 kDa spin-filtered digested wheat gluten, with or without prior heat treatment, at 100ºC for 30 min and centrifugation.RESULTS: There was no difference between diets when comparing differences between bioLep and total leptin levels and their ratio in the 13 participants, three women and 10 men, aged 52-74 years with a mean BMI of 30 kg/m 2 and a mean diabetes duration of eight years. We found no carry-over or period effect for bioLep and total leptin. In vitro, wheat gluten digest inhibited leptin binding in a dose-dependent manner but not after heat treatment. CONCLUSIONS: We found no leptin binding inhibition after the Paleolithic or diabetes diet, possibly due to its abolishment from cooking-related heat treatment of wheat gluten.TRIAL REGISTRATION: Registered on 14/02/2007 at ClinicalTrials.gov Identifier: NCT00435240.
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| 13. |
- Fontes-Villalba, Maelán, et al.
(author)
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Palaeolithic diet decreases fasting plasma leptin concentrations more than a diabetes diet in patients with type 2 diabetes : A randomised cross-over trial
- 2016
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In: Cardiovascular Diabetology. - : Springer Science and Business Media LLC. - 1475-2840. ; 15:1
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Journal article (peer-reviewed)abstract
- Background: We have previously shown that a Palaeolithic diet consisting of the typical food groups that our ancestors ate during the Palaeolithic era, improves cardiovascular disease risk factors and glucose control compared to the currently recommended diabetes diet in patients with type 2 diabetes. To elucidate the mechanisms behind these effects, we evaluated fasting plasma concentrations of glucagon, insulin, incretins, ghrelin, C-peptide and adipokines from the same study. Methods: In a randomised, open-label, cross-over study, 13 patients with type 2 diabetes were randomly assigned to eat a Palaeolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts, or a diabetes diet designed in accordance with current diabetes dietary guidelines during two consecutive 3-month periods. The patients were recruited from primary health-care units and included three women and 10 men [age (mean ± SD) 64 ± 6 years; BMI 30 ± 7 kg/m2; diabetes duration 8 ± 5 years; glycated haemoglobin 6.6 ± 0.6 % (57.3 ± 6 mmol/mol)] with unaltered diabetes treatment and stable body weight for 3 months prior to the start of the study. Outcome variables included fasting plasma concentrations of leptin, adiponectin, adipsin, visfatin, resistin, glucagon, insulin, C-peptide, glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1 and ghrelin. Dietary intake was evaluated by use of 4-day weighed food records. Results: Seven participants started with the Palaeolithic diet and six with the diabetes diet. The Palaeolithic diet resulted in a large effect size (Cohen's d = -1.26) at lowering fasting plasma leptin levels compared to the diabetes diet [mean difference (95 % CI), -2.3 (-5.1 to 0.4) ng/ml, p = 0.023]. No statistically significant differences between the diets for the other variables, analysed in this study, were observed. Conclusions: Over a 3-month study period, a Palaeolithic diet resulted in reduced fasting plasma leptin levels, but did not change fasting levels of insulin, C-peptide, glucagon, incretins, ghrelin and adipokines compared to the currently recommended diabetes diet. Trial registration: Clinical Trials.gov NCT00435240.
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| 16. |
- Persson, Johan, et al.
(author)
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Feeding of double disc refiners - modeling of particle flow
- 2018
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In: IMPC 2018. - Trondheim, Norway.
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Conference paper (peer-reviewed)abstract
- Improvements to the energy efficiency of double disk refiners are hampered by the feeding rate in tothe machine. This study aims to evaluate parameters towards a complete model, which will help tobring clarity to the limiting factors in feeding rate. A combined computational fluid dynamic anddiscrete element model is used to evaluate the flowrate of a hopper discharge unaided, and aided by agas flow with varying density. The results of the study shows that it is essential to capture the exactgeometry of the double disk feeding in relation to the woodchips in the complete model. The resultsalso shows that while it is essential to include the gas phase in the full model, the model is not sensitiveto small variance in the density of the gas.
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| 17. |
- Persson, Johan, et al.
(author)
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Feeding of double disc refiners – rotor design evaluation
- 2022
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In: Proceedings of the International Mechanical Pulping Conference. ; , s. 69-
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Conference paper (other academic/artistic)abstract
- This work presents a hypothesis of how steam flow effect the chip flow in the Double disc (DD) refiner and test it with a numerical simulation. DD refiners are often considered one of the most energy efficient refiner models. However, feeding chips into these machines is not as easy as feeding single disc refiners due to the rotating geometries. It is our belief that to increase energy efficiency in refining we need to increase also the production rates. The authors have previously noticed that in a standard DD rotor, steam flowed both in the same direction as the flow of woodchips and in the opposite direction. It is our hypothesis that backwards flowing steam in and in close proximity to the critical transition from the non-rotating geometry to the rotating geometry is negative for the material flow. To evaluate the hypothesis a new rotor was designed to eliminate the backwards flow. The authors have previously presented a two way coupled multiphase model with steam flow modeled with Computational Fluid Dynamics and wood chips modeled as groups of connected spherical particles with Discrete Element Method with a momentum exchange model. This model was utilized to model the flow of steam and woodchips in a DD under normal operational parameters, with the conventional rotor and with the new rotor. The throughput of wood chips was evaluated and normalized with regards to the chip flow to the refiner. The flow was considerable more stable in the new rotor, the throughput was close to 100 % for the observed time window, and the steam flow was more uniform. The results of the simulation supports the hypothesis. The next step in the research would be to test the new rotor in full scale operation.
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